tv Charlie Rose PBS August 31, 2011 12:00pm-1:00pm EDT
stf. >> charlie: welcome to our approach. we continue our summer recess composite, this evening calling it different men, different professions. we begin with a man called bill gates whose favorite teacher is salman khan. >> i probably would have produced sething different, got fancy lighting put make up onand got computer graphics and probably produced a lot of the education material that's already out there. >> charlie: next is the war hero eric greitens. we all have a place where our homes for the future and the people we love come right up
against the reality the world presents to us. what i'velearned doing humanitarian work with refugee families going through navy seal training working with wounded veterans we all have an untapped capacity for courage. >> charlie: from a world of medicine a man who won a litzer prize for cancer dr. siddhartha mukherjee. >> the brakes are a fundamental part of the car. you can't imagine a car without the accelerator and brakes. if you jam the accelerator inappropriately or snap the brakes become unable to stop. >> charlie: we go to haiti and other places. >> listening how haitians define themselves -- every haitian can
captioning sponsored by rose communications from our studios in new york city, this is charlie rose. >> charlie: salman khan is here. he provided ten minute to tts on the web on everything from math to science to finance. the harva mba and former hedge fund manager has become an on-line teaching sensation. here as look. >>t a hypotenuse is now going to be five. this animal fossils are only found in this area of south america, nice clean here and
this part of africa. we could integratet over th surface and the notation is usually a capital sigma. if these things end up being worth $.30 on the dollar. let's sawe go to some future state and these really are only worth $.30. the most the private investor loses in this situation is his $7. if this does not blow your mind then you have no emotion. >> charlie: i'm pleased to have sal khan at this table. welcome. >> thank you. >> charlie: you have a position to tell others. >> i think so. yes that's with a i've turned into. >> charlie: what have you turned into. >> i've turned into someone, i guess from my point of view who gets to, i started off with the math and the physics and the science and the economics. something i knew fairly well from my background but now i've turned into someone who gets to learn pretty much anything and
disstill it down and teach it. >> charlie: you're learning new things, distilling them and then teaching them. >> yes. >> charlie: give me the background you have. >> as you mentioned five, six years ago i was an an i was at a hedge bubbled. before i was my background was in software, did the business school and did the hedge fund thing. while in boston i had family visiting me from new orleans after my wedding in 2004. my cousin nadia, i remember we were waiting for the fireworks over the charles rivers and we were just killing time and itches giving the brain teasers that you give at a software interview for 25 year old engineers. most people disengage, i don't want to deal with that or think right now. she was a 1 year old, don't tell me the answer i need to figure it out. can they see each other and all these type of things about the brain teaser. i was pretty impressed and i started telling her and her mother hey you should think about becoming an engineer or whatever. the next morning her mother told me thanks for believing in nadia
but she's actually being tracked into a slower math class like the non-advanced track. i said that's impossible the thing she was doing yesterday is way beyond her. she did bad on the placement exam. when nadia woke up sheaid what's going on. apparently she had bombed units converting gallons to quarters. i can understand you're cousion but the thg you were doing last night harder than units. in you want to work with me here in boston i think we can get you past whatever hurdles you have. she agreed and they went back to new orleans and every day after work i would come home and we'd get on the speakerphone for half an hour or hour and i started working with her. it worked out. two or three months she got up to speed went ahead of the curve and i start tutoring her brothers, other family members. and then you fast forward to 2006, 18 months have gone by and
i was venting to a buddy. that's a lot of fun i'm having. by this time i moved out to california. this is a lot of fun, it's really satisfying. but the first time you give a lecture, it's kind of fun. the second time it' still fun. the third time i starts to get tiring. and he said -- >> charlie: do it one time. >> do it one time. why don't you put i on youtube and i said know, youtube's for dogs on stes boards. it's not for serious learning. once i got over the fact it wasn't my idea i decided to give it a shot and i pu it up ther >> charlie: when did it become an academy. >> you ft forward, it soon became clear like maybe the six months even from the beginning random people started watching it. fast forward six months i probably had 50 or 100 videos. i started getting these random letters from people. if you look on youtube peoe aren't that cil in terms of what they write. but they were writing i was
going to flunk calculus until i got this video. i wasn't going to become an engineer until i saw that video on vectors or whatever it might be. so it started to dawn on me this could be more than a hobby although it stayed a hobby right then. i think the first time it was either 2007, i decided to set up my own domain name. so have anher way of viewg the videos. i also started working on the software for my cousins. i was working for a hedge fund called wool capital and my boss was dan wool and i'm sal khan so i thought kha and a half. academy. >> charlie: what are you honeying. >> i'm hoping it can turn into, i don't want to say rivals but so of the conversations. >> charlie: in the places where you can learn. >> in the places where usual learn at a very high level.
so you can start at arithmetic, you can go deep and it's a real learning experience. it's not something superficial. >> charlie: how many people work for you. >> we have eight people. we had sixf you asked last week. >> charlie: eventually you'll give diplomas. >> that's an open question. if you focus just on k-12 and our video content goes well beyond k-12 but this one k-12 right now what really matters is some of these standardized test, the sat's and ap tests. high school diplomas, kids are getting into harvard being home schooled right now. we see our real niche right now on the learning side. it's learning and credentialalling. we'll tackle the learning and in the future we'll see what we can do on the credentialing. >> charlie: who are the people watching. >> a certain subset of people, those who like to watch the discovery channel and charlie rose and all the rest.
so i'm really focusing on the intuition and going deep and showing how it connects and all of these things sometimes gets lost in textbooks and classes. the surprising thing is i get letters from that group of people but i do get letters from parents of students with learning disabilities, kids who were otherwise disengaged from math class or from school generally and over here they l of a sudden discover a love. >> charlie: that is the most important question that comes out of this conversati between the two of us. what is it you know, what is it you do that somehow makes learning more attractive, more intesting, more satisfying and more productive. >> i don't know that i definitely have the answer. i have guesses. >> charlie: guess. >> yes. i started off making it for my cousins and i didn't care and i was kind of this liberated person. if someone told me in 2004, i'm going to give you a come million
dollars and bill gates will watch it and all the rest. i probably would have done something different, get some lighting and make up on and computer graphics and produced a lot of the education material that's already out there. the computer graphics the next stage of photo synthesis. but i think the reality is that's what we all assume as go content but when someone watches it's so dehuman izes. peop can tell it's some dude he's not getting paid he's make it for his cousins. there's a human element to it. a lot of time when people are trying to get people engaged into math they try to distract like them a rap song or play music and people find that patronizing. don't distract me, if math is good it should be able to stand up on its own. >> charlie: that's what i thinks about the show. it's a black room and just a conversation between interesting people. that's all it is and that's what
people want. >> you're not insulting people. if you have bells and whistles it's not worth watching. >> charlie: you'll learn a whole lot here and this kind of conversation will penetrate that veil of mplexity and give you a channel to access complexity. >> i wholeheartedly agree. maybe i was self consciously inspired. >> charlie: when i hear you say the i realize that's exactly where we approach. that's the mind set as well. what's the hardest thing about this? 24 hours in a day. >> 24 hours in a day. now the hardest thing is i want me to be continuing to make videos. i want most of my day kind of the learning and the producing. >> charlie: but what? >> and this is another interesting thing about khan academy because i put videos out there and people watch them and i'm kind of associated with them. i can use that as a platform to i guess ion gauged in the discussi, however you want to view it. but i still think my biggest
role and probably the highest leverage from a my time are those videos and even though that video on-line intervals in the firsteek might only be watched by a few hundred people i think over the next hundred years, that will be, that will be a big impasse. >> charlie: what's wrong with the way we teach? >> i tnk it's more than wait we teach. 's a systemic thing of how the school is structured. right now you have, you and i were sitting in an algebra class, prealgebra class and they're going over negative numbers and maybe you get a 95% on the exam, get, you feel good about yourself, you get an a stamped on your forehead, whatever. i get a 70%. so there's an assessment and it does ideify i have big weaknesses, you have even some weaknesses. you have 95%. there's still 5%. negative numrs are the core thing. you need to know that really
well. despite that the whole class moves to the next consent and assumes everyone had mastery when no one does. so you keep marching everyone down that path and we've all seen this with ourselves and family members. everyone hits a certain math class or science class where they hit a wall and that a student or b student start flunking. they he good teachs and trying to study. it's because they have these gaps. there's no way to identify the gap in fourth day or precalculus or algebra gap. there's the problem. no matter how good a teacher you have, you have a weak foundation. >> charlie: do you ski it as supplementary to the process of education or the main line in the process of education. >> our goal is that with khan academy alone, if there's a student in calcutta, maybe the internet connection, that's a
gating factor but if they're there, they can get a pretty solid grounding in a lot of different subject areas especially ones that are meaningful to them that they can use to progress. but we think it can be the operating system what can happen in the classroom to really liberate what happens inside of the classroom. >> how many of them do you do yourself? >> i produced all the videos. >> charlie: that's what i thought. >> i'm the faculty. >> charlie: you are the faculty. >> my meetings are non-bureaucratic. >> charlie: that's assume you're interested in napoleon and the french revolution. how do you prepare. what's the process going from i'm curious about napoleon to this is what i have to teach you. this is your access to understand this moment in history. >> yes. once again i approach it from what my brain would like to see. like for history, i immerse myself in as much as possible. i usually read the wikipedia entry first. >> charlie: i go f the
scaffold myself. i want to see where it fits and the jog knee of the place and what it looks like. >> also wikipediaf i find co maps, i copy and paste make sure they're in the public domain. stick it on my back board art program. sometimes i'll draw a time line to make sure i get the years right. but the main thing i do whether it's history or chemistry or ything is get the scaffold and then really immerse myself for however long it takes and then make sure i can make intuitive connections between evything that happens. >> charlie: what kind of intuitive connection? >> understand why something, if i'm doing it on the neuron, why, you know, an algebra took of book will tell you a signal goes across because of the myelin sheath how does it make the material go faster. no book will tell you that answer.
i'll pder it a bit and it's kind of like a fiber optic system. then i would call up some buddies who are either biologists or communication engineers, does this make sense. no, i think you're right. it's a big deal for meto, if i do biology, why does the myelin sheath make the signal go faster. fits history, why did this artillery captain all of a sudden come to power. weren't there other people around. these obous questions are important for me to answer. and what's really com is sometimes you call a buddy. i know you think i'm stupid when i ask you this and you think i have no business making a video on this because i'm asking the questionut why does the reticulum release these ions when this haens. he goes do you know what, we don't know. why doesn't the book tell me that. >> charlie: so what are your former colleagues at the hedge fund say. >> they're super happy bit. i mean my last boss told me if i knew you were going to do this,
i wouldn't have hired you. >> charlie: it's great to find something that you have great passion for. and it involves learning yourself. >> i think i subconsciously been inspired by you. years ago i said charlie rose has the best job. he gets to learn everything. i'm doing it my own way. >> charlie: it's great to meet you. thank you very much. >> thank you. >> charlie: one of the military's most elite forces. they carry out the most dangerous combat mixes in the world. joining me is eric greitens -- the making of a navy seal. i'm pleased to have him on this table for the first time. welcome. >> thank you charlie. >> charlie: why the navy seals when you thought about your own history andou thought
about the demand of being a navy seal. >> there was a moment for me where i had to make a choice about how i was going to live. i wa finiing my te at oxford and i written a ph.d. on how international humanitarian organizations work with kids in war zones. i remember i was at this event at rhodes house. rhodes had started it and i ricia i walked into rhodes' house and i looked pop and in the rotunda there, i saw that the names of american rhodes collars who had left the university, had left oxford in world war ii to fight were etched into the marble. these were people who left to night and subsequently died. i remember looking up and thinking if they hadn't made that choice that i wouldn't be here looking up at them. i was really fortunate in my
life. i had so much wonderful teachers in college and graduate school who invested me and i felt i needed to be of service as well. i eded to find a way to pay back. >> crlie: you read about heroes a appreciated heroes and you were worried you might not live in a time in which heroic action was called on. >> as i kid, i read all of these great stories about the nights of the frontiers. we're the great causes. it seems to me like celebrities and sports figures had all the attention. i was trying to search for my purpose and ultimately i found that doing service to others, doing humanitarian work and service in the field. >> charlie: you call the book the heart and the fist. >> yes. so the idea is we all have to life with both courage and compassion. sometimes we live in a society
where people want to make a distinction between what it means to be good and what it means to be strong. i think that inrder to do anything well, in order to love anything well, we need to live with both courage and compassion. and that's the idea behind the heart and the fist is that the heart provides us with our direction, provides us with our purpose, with our passion. but to follow that passion requires every day perseverance and it requires discipline and it requires courage and it's that combination of passion and perseverance that helps people win the fights on their frontline. >> charlie: you talked about your colle education. you weren't thrilled by college because itas duke but because it was college. >> when i went to college i remember first commerce of my freshman year i was so disappointed because i expected to be thrown into this great experience that was going to help me to become someone who could -- >> charlie: a love affair with learning. >> and a love awe anywhere with learning exactly. >> charlie: it didn't happen. >> it didn't happen at first.
eventually it d i ended up getting an incredible education at duke university. i had wonderful professors buti had a boxing coach who was really an important part. >> charlie: you had a find of joy about learning and about the pursuit of the poetry of life. >> yes. one of the thing that was so great about oxford is that even when i was doing a mters degree, you didn't he to do a lot of, there wasn't this constant daily pressure behind the academicork, you were free to pursue anything that you wanted to do. and all you had to do at the end of two years was to show up and pass an exam. as long as you were on track to do that, you could pursue whatever intellectual interests you had and then combined with that oxford had these long breaks so i could leave oxford and i could go to work with mother teress missionaries of charity. i could go to cambodia and work with kids lost in land mines. i could go to albania.
it was that ability to combine that great intellectual freedom with the possibility of doing that service work abroad that made for a great education. >> charlie: ou get out of oxford, you're 26. in order to get into the navy seals, you have to be less than 28. >> yes, exactly. >> charlie: why the seals. >> part of what was the attrtion of the seal meese was this incredible test. a lot of people have heard about bund, the basic under water demolition seal training. it's considered to be the heart es military training in the world. >> charlie: why is it considered to be the hardest. >> they put you through some incredibly tough tests. they ask you for example to swim 50 meters under water in your first week. they later ask you to swim down 50 feet and tie a knot. they do things like drown privileging where they tie your neat together and tie your hands behind your back and make you jump in the pool. swim 50 meters with your feet tied together and your han tied behind your back. in our class we had over 220 people in our original class and we went down to 20.
>> charlie: 10%. >> 10% of us made it through in the original class. >> charlie: those that don't make it you have said is because fear. >> yes. >> charlie: overcame you. >> yes. >> charlie: the thing that had the people who succeeded, what did they, how did they handleear. >> so what happened, as you're going through buds, you are pushed to your physical mental and emotional limit and passed. you're pushed way past the envelope of your talent, the core of your character. what happened is everyone is in great pain. everyone is afraid. in great pain, searing pain. when you're going through a lot of the physical training. real serious pain. but what happens is, people either start thinking about themselves and they think about all the pain that they're n they think about all the fear about what might happen. and that leaves them to collapse. others who are in that great moment, i remember for myself thinking if i were alone i might
not make it. there's a guy to my left and there's a guy to my right and they both need me to be stro. if you can step outside of yourself that's what gets you strong and that's what gets you through and that's what creates these incredible teams. >> charlie: how d you put that experience in contrast to everything you've done with your life? >> going through buds, going through healtheek was for sure the hardest physical experience that i've ever had in my life. it was also, i would say, we call it the best time you never want to have again. >> charlie: do you think that we all would be better for ourselves if we demanded more of ourselves and challenged ourselves more physically than we do and that we somehow were able to develop more confidee because we succeeded in a challenge that we could fail. >> i think that's how people could develop can -- confidence you push yourself to a point of
fear and pain and you find you can be successful and we find the xt challenge. all need to push ourselves but in orderto do that effectively youlso have to have the right kinds of teachers and friends and mentors to hip you along that journey. >> charlie: you were there, you won the bronze star in afghanistan. >> in iraq. >> charlie: you went to iraq and afghanistan. >> i did. >> charlie: so what did you do? >> so when i was in iraq, i was serving as the commander in the al-qaeda talking cell. my mix was to capture mid to senior level al-qaeda. if you can capture one of the al-qaeda and you can why use it fofurther pressure. >> charlie: how did you first learn of the killing of osama
bin laden. >> i was on a flight from st. louis to philadelphia when my flight touched down i turned my phone on and i saw there was a text message there that said obl, osama bin laden is kai. hua is one of the seal crs and that's a friend of mine i had served with who is telling me osama bin laden had been killed. >> charlie: it's very important for seal team six to be anonymous to the res of us. >> i think it's so important that we don't even discuss the unit designations or names because we have to make sure that these particular units and certain tactics, techniques and procedures, we want to keep them secret so that these men can continue to put pressure on the al-qaeda network, continue their operations in the war on terrorism. >> charlie: so you complete your service. >> yes. >> charlie: you go to a hospital and you see fellow soldiers there. >> yes. >> charlie: and you decide
what? >> so i went into bethesda naval hospit, talked with these youn men and women 20, 21, 22 years old and they had been seriously injured. one of them lost both of his legs. of the lost the use of his right arm and part of his lung. another lost a good part of his hearing so i said to each e of them what do you want to do to recover. they all say to you i want to go back to my unit. i want to go back to my unit. but the fact was that they weren't going to be able to go back to their unit. and you know, one of thing lost both of his legs like i said and i wasn't going to be able to go back to his unit but he still wanted to serve. when i asked him i said what would you want to do if you can't go back to your unit right away, he said to me i'd really like to find a way to go back home and be a teacher. another wanted to be a police officer, another one said to me that he wanted to find a way to go home to be a football coach
and a mentor. it just became really clear to me that all of these men still had a desire to serve. and that in addition to hearing thank you, they also needed to hear from all of us we still need you. so i left the monday i called two friends who were disabled veterans they put in their moneys from the disability checks i contributed my combat pay and we used that and the mission continues. at the mission continues we helped wounded and disabled veterans to continue their mix of public service by working in our communities he at home a citizen leaders. >> charlie: where do you think i'll find you in five years. >> i think in five years the mission continues along with other associated veterans organizations who won the fight for this generation of veterans. right now that's the link to see this generation come home. they live wit the heart and fist here at home.
beyond that i could imagine many things but i'm not sure exactly. >> charlie: politics? >> i have thought about politics. i've been asked to run a number of times since i've come home from iraq and i told people no because the mostmportant thing i can do right now is to win this fig for this generation. >> charlie: you want people to come away reading this book, this story of you and the story of the seals and the story of your inpassion and commitment to humanitarian activities. with what? >> i want people to know we all have a front line in our life. we all have a place where our hopes for the future and our hopes for the people we love come right up against the reality that the world presents to us. what i've learned doi humanitarian work with refugee families going through navy seal training working with wounded and disabled veterans is that we all ha an untapped capacity for exarnlg. we're you unable to tap int the capacity for courage, then we
can win those fights. >> charlie: tom brocaw who urged me to read this book and urged me to have eric on the show says about this book meet my hero eric greitens the heart and fist are just the combination that we need. thank you and good luck. >> thank you very much. >> charlie: joining me now is dr. siddhartha mukherjee he's the professor of medicine at columbia. th book is called the emperor. welcome. >> thank you. >> charlie: why does cancer need a biography. >> i started writing this as a history of cancer. the book really grew out of a question a patient asked me and the question was, she was a woman who had been battling abdominal cancer and she said to me i'm willing to go on but i
need to know what it is that i'm battling. i need to know what i'm fighting. so the book is 600 page answer to her question. but the word history, which is how i had visually imagined the book history of cancer is what it is just seemed two inert. as it's writing the book it's taking in stories of my patients, the history of patience and was seeing i was looking at some thing but at someone and hence the word biography. >> charlie: what is it? >> well i think that there's a fundamental thing that it is is that it's a patlogical pro-fe risk of cells occasionally cells that don't know how to die but ctainly cells that don't know how to stop viding. that a pathological proliferation of cells is a process that starts up typically in a single cell and it goes and multiplies over and over again. th's what cancer is. i would immediately stop them
and say but every different cancer has a different face. >> charlie: and you believe that we will find prevention, cure. >> i'm optimistic we will find prevention and cures for some cancer. i don't think there will be a single magic bullet. i remember in the 1970's, there's an old idea from the 19th century that there would be a single magic bullet, so-called penicillin for cancer. this phrased was bandied about a lot and really laid to rest i think. we will never find a penicillin for cancer. that said we will convert some cancers into chronic diseases during our life times i think the answer's yes. we alrey have to some extent. >> charlie: is there something really remarkable about cancer cells. >> it is an astonishingly adaptive moment to allow a cancer cell to come out of our bodies. the seminal discoveries about
cancer biology is the enact vasion of genes that are already present every cell. it's not as a cancer occurs becaus of some virus typically, there ar cases that are certainly that. but one of the cancer of course because -- >> charlie: go ahead. something turns on. >> something turns on inappropriately o turns off inappropriately inside every cell. but the thridges that are turning on and turning off are genes that have profound normal functions in every cell. so in other words it's begin the analogy has been often made cancer's like a car. when the car works cancer cell is like a car. when the car works properly its accelerator and brakes is a fundamental part of the car. you can't imagine the car without acceleration and brakes. yet if you jam the accelerator
inappropriately or if you snap the brakes inappropriately, then this car which is adapted to accelerate and stop, begins to become unable to accelerate and stop. >> charlie: it has a life of its own. >> exactly. you got to admire the extraordinary mechanism that's inside every one of our cell that alls this automatic process of acceleration and braking happen normally. the fact that we grow up as these incredible organisms. metimes i say to myself it's extraordinary we're not exploding with cancer. it's a momentin our evolving with organisms that these accelerators and brakes don't get broken all the time. and therefore you have to admire what an extraordinary thg is when it does occur in a human body. >> charlie: what's the key to finding a cure and/or treatment? >> well the key really is to go back into the fundamental
biology of the cell, is to return back to the mechanistic understanding of what cancer is. to understand what are the mechanisms what are the accelerators and what are the brakes and how do those accelerators and brakes referring to the breast cancer cell from a leukemia cell. again to go back and find the exact alterations -- >> charlie: have we found it in any particular cancer. >> we found it in man cancers. the picture's still incomplete but we found it in many cancers. we know in fact the cancer gee nierj project which is really the adverse o the human genome project is precisely direct to ask me this question. to remind you the cancer genome press is the catalog, producing a catalog of all the mutations that occur in a ccer cell compared to a normal cell. when have you that entire catalog laid out you can say well this breast cancer has mutations and gene x, y, z and a. this other breast cancer cells may have mutations in genes p,
q, x and z. and thereby recategorize the entire universe of cancers in terms of these fundamental genetic changes and genetic mutations. >> charlie: everybody says rly detection's important. what makes it important? >> well, you know what makes it important is that cancer is a diseehat metastasizes and it's actually typically not always but it's typically a metastasis that kills patients. it's metastatic cancer california that kills patient. in you can track the cancer early, if you can get the crab while it's still locally under the sand and remove it thin you have the capacity of being cured. that's what happens when an early tumor is detected by a mammogram for instance. when you're trying to do in a mammogram is trying to say that's a very early stage cancer let's take it out before it spreads. now threason that doesn't work all the time is even small tumors can spread. so size makes a difference. early stage tumors can be
detected by man gra but not every small tumor is at an early stage it's spread and metastized outside the body or the press. >> when you look over the past 20 years is there something we could have done that was obvious besides spending more money that could have brought us to a much better place. let's thank you abouthe question for money for one second. the nci budget is $5 billion give or take a little change. some people think that's a e noamples amount of money. we spend $900 million on this war so the war on cancer is a pittance compared to several military campaigns tt the country has run and is continuing to run. let's put that into perspective. >> charlie: how many people did cancer kill in 2008. >> 600,000 men and women this last year in america alone. >> charlie: 600,000. >> that's right. you have the numbers. >> charlie: relapse happens.
why does it happen? >> the quick answer is we're not sure. it happens because of several mechanisms. one of them is the same mechanisms which is the tumor hasn't been excavated enough. we haven't taken enough of it out. that's local relapse. the second reason it happens is that cancer cells grow resistent to drugs so that's relapse to resistent. perhaps the most controversial, the most interesting idea that's been advance and i've written about it a little bit in the book is cancers possess still like cells. these are cells sort of like the root. >> charlie: smoking is a cause. >> absolutely smoking. >> charlie: very doctor says that. not that there's a question about it. >> yes. >> charlie: the reaction is exactly like yours. >> yes. someone rently asked me well what preventive things should i do in order to, what five preventive things should i do in order to not get cancer. i said well the five are stop smoking, stop smoking stop smoking stop smoking. >> charlie: there are certain stories about that. if you have not smoked for 10 or
15 years, then ... >> there always to be the situation. but if you stop smoking for set years you actually revert back your risk mewhat to the normal range. in fact even if you are smoking, it's important not to be realistic about it and say there's more to come. and that stopping quitting, can actually make a difference to your prognosis. the story of how smoking got discovered as how tobacco smoke was considered as a carcinogen is an amazing story. >> charlie: what's the story. >> the story is smoking had become so common at one point in time that you couldn't discern a like between smoking and cancer. it was like as richard pito said to me, is there a like between sitting and cancer. everyone sits and some people get cancer so how could you possibly run a study to discern a like between sitting and cancer. and it was the two scientists, two pairs of scientists winder and graham in america and dole and hill in england who really
uncovered this link. winder and graham are very interesting characters. graham was an important surgeon. he actuay devised a mechanism he inventethe removal of the lobe of the lung for lung cancer. when winder was a student went up to him and said do you think there's a link between smoking, smoking is going up, lung cancer is going up could there be a link and graham said so has the use of nylon stockings. how cod there possibly be a link. it was invisible. through this inkriebl careful epidemiological studies where they followed doctors prospectively over time that they began to discern the link that those who smoked died of long cancer while those who didn't smoke didn't die of lung cancer. >> charlie: what's the most deadly cancer. >> the list of culprits is quite nasty but among the big ones
these days, pancreatic cancer. >> charlie: yes that? >> begin, we're not sure we know. part of the reason we think, part of the reason is that for some reason chemotherapy or other drugs don't seem to get into these tumors easily. that's not the only reason, there are other reasons as well. the genetics of this tumor is probably quite complex. many different accelerats and brakes broken as it were. so getting therapy against this tumor is another problem. and then a third reason is its insidious. it's not an eyes detection test. it's not like you have a mammogram for paneatic cancer. it preants typically in stages. >> charlie: we always ask this question. what is the one question we most want to find the answer to? >> well the one question that i think is really burning right now is how one converts the weth of genetic information that's slowly coming out of
these cancer genome projects into prevention mechanisms. how does one do that. the best way to engage a new bunch of chemists, make new drawings and new mechanisms by which we can find early signs so that we can prevent cancers. can we essentially create preventive mechanisms that live in a petri dish we don't launch enormous even dame logical studies until cancer comes out in the population and say oh it must have been this or smoking. in ery direction, prevention and therapeutics direction, we need to find out how to connect the wealth of information from this project towards finding prevention and therapy >> charlie: the emperor of all maladies, the emperor of cancer. siddhartha mukherjee, thank you very much. >> charlie: paul farmer is
here, he's got the highest arne harvard can give a professor. he's a physician and anthropologist. in 2009, president cnton nam him a special envoy for the of haiti. he's written a book called haiti after t earthquake. i'm pleased to have him o this program for the first time. it's long overdue. welcome. >> thank you charlie. >> charlie: how many years have you been going to haiti. >> 28. >> charlie: why? >> i went there just having graduated from college before medical school. i knew i wanted to be a physician and i was very interested in, i wouldn't comet medical mission work but in serving people, might not otherwise have access to healthcare. and i ended up in haiti on purpose and studied the place as a college student. and i'm really glad i did. so that was -- >> charlie: so what is the iti that you knew preearthquake. >> rural haiti. the central plateau, people who
make their living by farming the land. i think the term would be, i had the good fortune to start my work in a very disrupted community. they had been displaced. it had been displaced by a hydro electric dam th was not the best way in some since to see aevelopment project but to see one that was viewed pretty dimly by the intended billion fisheries. it was just a good way to learn about the down side of development work and to try to do a better job. >> charlie: president clinton and others have expressed this idea. in the huge tragedy for the people who lost their lives in e earthquake, the devaation it did to a country that somehow come out of this might be some hope for haiti. do you accept that idea. do you believe that believe, that idea turning to reality? >> i do accept the idea.
i think, and maybe because in my line of work, we need to have some goal and that's been true all along in providing healthcare services to people living in poverty. it may be simply that i need to believe it's possible but i also belie that we cannot just build haiti back better which is begin been the goal of the haitian people all along. we can also build development back better. just to goack to that experience as a young american 23 years old seeing this hydro election dam. it wasn't done the right way and displaced a lot of people. they're unhappy about it, still are and i think the notio of building back better goes two pa. one the infrastrucre and the institutions of haiti but al the waive we do business in
human tailor work and development work. >> charlie: where are you when you first knew about the earthquake. >> i was in miami and we had just left haiti. my family was headed back to rwanda where i've also been working and had no idea why i would be getting a call from a friend in washington that evening so i heard about it then. but really took a long time -- >> charlie: sharyl mills called you. >> it was sharyl mills and was good enough to let me know. she thought i might be in haiti. she knew i was down there are for the holidays. ani had no idea of the dimensions that the quake but also the impact on the city on the infrastructure itself. >> charlie: when you, so you turned around and went right there. >> i went to join president clinton at the united nations the next morning. and there was no getting in and
out of the airport except through, and the commercial traffic was close. and so i came here to new york the next day, there was a session on haiti. there were some, a friend of ours who had been working with haitian diplomate, he hadome up for a meeting here. i came and met them and i went directly from new york. >> charlie: you have said and i think right in this book everyone knows i haiti or people involved with haiti knows where they were a the 4:53 on monday january 12th. you remember exactly where you were i you were in haiti. >> a lot of people, i've shared that experience, we say where were you that day. we're in haiti. we're outside of haiti. we can tell you exactly where we were. >> charlie: so when youlew back. >> i flew back, i remember it
was a long, we were circling around the airport for a long time. again, there was the airport was closed for a long time to commercial traffic but i remember looking at the window and it was turning dark. and it was with a team, a medical team surgeons, father/daughter team and some other physicians including a haitian colleague. and we were circling around and you just saw there was no electricity. it was just blacked out down below except there was some small fires butthat's what i remember, it was so different because there weren't any lights where thereusually were lights. the power grid was of course taken out by the quake. >> charlie: you also have said that when you first heard this, you know port prince is one of the bigger cities. >> when there's a rain storm there are casualties. it's a very crowded, everyone
knows how crowded it is. on the mountain sides it runs down right into the water. so it's fragile in the best of seasons and as erosion continues in haiti becomes more vulnerable to ecological to mud slides. >> charlie: what kind of coordination was there between organizations. >> it was difficult and there's some of that difficulty was born over again the telecommunications system's out, the power grid. so just the logistics of communicating was not easy. and then agai there's been a real pro-life risk in haiti of non-governmental organizations, it's well-known now. and as the, as there's been chronic weakness in the public sector and the governmen the breach has been filled, the void has been filled to some extent by ngos. again i'm part of that movement the world of ngos but we have
to do more to strengthen the public health and public education systems. >> charlie: other than poor, how will you characterize haiti? a developing country? what is it? >> i think list thing to how haitians define themselvesas been very instructive to me. anagain i can speak for l haitns. i've worked mostly in the rural areas but every haitian can tell you about the history of haiti and its being born in response to colonialism really and that's pretty important in haiti. and i think it would do us well to listen very closely to the way haitians see their future. >> charlie: and if we listen. >> they would say we need to streeten haitian institution and haiks health and haitian public information and build haiti. there's no replacement for that. so i don't found like i'm being
ideologic,n't example for me in medicine could be how could a group like ours partners in health or othergroups, how can we strengthen public hospitals in haiti rather than trying to build our own parallel system. >> charlie: are you satisfied with the responsef this government and this president? >> the american government? >> yes. >> i think there's been an enormous amount of effort put into try and do things a little differently than has been done in the past. >> charlie: looking for a better w. >> looking for a better way. if you look back, haiti in the 20th centu.s. policy toward haiti in the 20th ceury you may as well start wit the american occupation. 1915 to 34. after this there was a fair amount of support for whoever showed up in charge and that included a family dictatorship. after the dictatorship there was a lot of back and forth in u.s.
policy. it was very disruptive. i think it's important to try and do this better as a nation. i think there are a lot of people of goodwill who are trying to push forward this agenda supporting haitian institutions and haitian development. >> charlie: what was the mistake of the government, to not do what? >> if you follow, for example -- >> charl: -- from one regime to another. >> exactly. and also failing to support the haitian choices in leadership, that is the haitian voter. i think that was a mistake. i think we're looking back over the last 25 years, we've had a very, we've been all over the map. our country's foreign policy supporting or failing to support often the haitian electric. and trying to under mind some of
the government. this is very unpleasant to talk or write about but i do think it's important to acknowledge. anin my line of work in public health, we can't do our work if we're only trying to advance our own agenda. we have to listen to what the haitian agenda might be and of course there are a lot of agendas in haitian. it's not that difficult. there's been two coups in haiti in the last 25 years. those are really, when there's a coup it's very disruptive for public policy, obviously. and it makes it hard to do. if you go to a battle zone, you can still have a field hospital and still transfuse blood and have operating room. but you really can't pursue public health goals without some level of social stability and i think that's going to come more quickly if we actually let nation people choose their own